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Global: ^IBUC(351.82

Package: Integrated Billing

Global: ^IBUC(351.82


Information

FileMan FileNo FileMan Filename Package
351.82 IB UC VISIT TRACKING Integrated Billing

Description

Directly Accessed By Routines, Total: 7

Package Total Routines
Integrated Billing 7 IB20P663    IB20P669    IBECEA36    IBECEA4    IBUCMM1    IBUCSP1    IBUCVM    

Accessed By FileMan Db Calls, Total: 8

Package Total Routines
Integrated Billing 8 IB20P663    IB20P669    IBECEA36    IBECEA37    IBECEA38    IBECEA39    IBUCSP1    IBUCVM

Pointer To FileMan Files, Total: 2

Package Total FileMan Files
Kernel 1 INSTITUTION(#4)[.02#351.821(.01)]    
Registration 1 PATIENT(#2)[.01]    

Fields, Total: 10

Field # Name Loc Type Details
.01 PATIENT 0;1 POINTER TO PATIENT FILE (#2)
************************REQUIRED FIELD************************
PATIENT(#2)

  • LAST EDITED:  JAN 07, 2020
  • HELP-PROMPT:  Enter the veteran who received care at a Non-VA Urgent Care clinic.
  • DESCRIPTION:  
    This field identifies the veteran who has been to an Urgent Care clinic under the Community Care Medical benefit.
  • CROSS-REFERENCE:  351.82^B
    1)= S ^IBUC(351.82,"B",$E(X,1,30),DA)=""
    2)= K ^IBUC(351.82,"B",$E(X,1,30),DA)
.02 SITE 0;2 POINTER TO INSTITUTION FILE (#4)
************************REQUIRED FIELD************************
INSTITUTION(#4)

  • LAST EDITED:  JAN 07, 2020
  • HELP-PROMPT:  Enter the site where the patient's Urgent Care Visit the bill was processed.
  • DESCRIPTION:  
    This field stores the site where the bill was processed.
.03 VISIT DATE 0;3 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 07, 2020
  • HELP-PROMPT:  Enter the date of the Urgent Care visit.
  • DESCRIPTION:  
    This field contains the date when the patient visited the Urgent Care clinic under the Community Care Benefit program.
  • CROSS-REFERENCE:  351.82^VD
    1)= S ^IBUC(351.82,"VD",$E(X,1,30),DA)=""
    2)= K ^IBUC(351.82,"VD",$E(X,1,30),DA)
    This index allows the system to find a visit in the Urgent Care Visit Tracking Database by the Date of the visit.
.04 STATUS 0;4 SET
************************REQUIRED FIELD************************
  • '1' FOR FREE;
  • '2' FOR BILLED;
  • '3' FOR REMOVED;
  • '4' FOR VISIT ONLY;

  • LAST EDITED:  FEB 07, 2020
  • HELP-PROMPT:  FREE - Exempt under the MISSION ACT of 2018, BILLED if a copay was filed, REMOVED if the visit was entered in error, or VISIT ONLY if the visit has no copay linked to it.
  • DESCRIPTION:  This field contains the visit status of the Urgent Care visit. The status can be: FREE if the veteran's visit is exempt under the MISSION Act of 2018, BILLED if the Visit was charged a copay, regardless of the copay's
    billing status, REMOVED if the Visit was entered in error, or VISIT ONLY if the visit needs to be tracked and there is no copay associated with the visit.
.05 BILL NUMBER 0;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>12!($L(X)<6) X
    MAXIMUM LENGTH: 12
  • LAST EDITED:  JAN 08, 2020
  • HELP-PROMPT:  Answer must be 6-12 characters long. Enter either ON HOLD or the full bill number associated with this visit from the Copay file.
  • DESCRIPTION:  
    This field contains the bill number under which a tracked Urgent Care copay was billed. It must be in the form of -. It is not a mandatory field.
  • CROSS-REFERENCE:  351.82^C
    1)= S ^IBUC(351.82,"C",$E(X,1,30),DA)=""
    2)= K ^IBUC(351.82,"C",$E(X,1,30),DA)
    This free text field will contain one of 3 values:
    If the Visit's status is not BILLED
    - NULL (no Copay associated with the visit).
    If the Visit'sstatus is BILLED
    - ON HOLD (A copay was charged but the Copay is waiting to see if
    3rd Party Insurace will occur). - xxx-Knnnnnn - the AR Bill Number (field #.11) from the Copay file
    (#350).
.06 REASON 0;6 SET
  • '1' FOR SC/SA;
  • '2' FOR MISSION Act;
  • '3' FOR Entered in Error;
  • '4' FOR Duplicate Visit;
  • '5' FOR No Copay Added;
  • '6' FOR FRM Override;

  • LAST EDITED:  MAY 01, 2020
  • HELP-PROMPT:  Select 1 for SC/SA, 2 for MISSION Act, 3 for Entered in Error, 4 for Duplicate Visit, 5 for No Copay Added, 6 for FRM Override, or if no extra comment is needed.
  • DESCRIPTION:  This field contains an extra comment to help describe why a veteran's visit was considered FREE, REMOVED, or VISIT ONLY. If used, the options to select from are Special Authority, Mission Act, or FRM Override (for FREE),
    Entered in Error or Duplicate Visit (for REMOVED), or No Copay Added (for VISIT ONLY).
.07 UNIQUE ID 0;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<5)!'(X?3.5AN1"_"1AN.AN) X
    MAXIMUM LENGTH: 30
  • LAST EDITED:  JAN 06, 2020
  • HELP-PROMPT:  Enter a unique identifier between 5 and 30 characters in the format 3-5 characters, underscore, 1-24 characters.
  • DESCRIPTION:  This field is used to determine the originating source of the record. It consists of the site number, an underscore, and the Internal Entry Number of the record at the originating site. Only the originating site can
    update the record.
  • CROSS-REFERENCE:  351.82^AUID
    1)= S ^IBUC(351.82,"AUID",$E(X,1,30),DA)=""
    2)= K ^IBUC(351.82,"AUID",$E(X,1,30),DA)
    This cross reference is used to lookup records by their unique identifier which consists of originating site, an underscore, and the IEN to this file at their originating site.
.08 ELIGIBILITY GROUP COMPUTED

  • MUMPS CODE:  X ^DD(351.82,.08,9.2) S X=X S X=X,X1=Y(351.82,.08,2) S X=$$GETELGP^IBECEA36(X,X1)
    9.2 = S Y(351.82,.08,1)=$S($D(^IBUC(351.82,D0,0)):^(0),1:"") S X=$P(Y(351.82,.08,1),U,3),X=X S X=X,Y(351.82,.08,2)=$G(X),Y(351.82,.08,3)=$G(X) S X=$P(Y(351.82,.08,1),U,1)
  • ALGORITHM:  IBUC ELIG GROUP(INTERNAL(#.03),INTERNAL(#.01))
  • LAST EDITED:  APR 07, 2020
  • DESCRIPTION:  
    This field shows the veteran's current ELIGIBILITY GROUP on the visit date. Since this changes sometimes retroactively, it is a computed field.
  • TECHNICAL DESCR:  This field shows the veteran's current ELIGIBILITY GROUP on the VISIT DATE. Since this changes sometimes retroactively, it is a computed field.
    It uses FileMan FUNCTION: IBUC ELIG GROUP(INTERNAL(#.01),INTERNAL(#.03)) which calls $$GETELGP^IBECEA36(X,X1) passing in the VISIT DATE and the PATIENT.
1.01 UPDATED 1;1 SET
  • '0' FOR EXISTING;
  • '1' FOR NEW OR UPDATED;

  • LAST EDITED:  JAN 06, 2020
  • HELP-PROMPT:  Enter 1 whenever this record is added or updated.
  • DESCRIPTION:  This flag is used to determine if a record should be pushed out to other sites. It is set to 1 when the record is added or updated and set to 0 after the updates are propagated to other sites a veteran has been treated
    at.
  • CROSS-REFERENCE:  351.82^AC
    1)= S ^IBUC(351.82,"AC",$E(X,1,30),DA)=""
    2)= K ^IBUC(351.82,"AC",$E(X,1,30),DA)
    This cross reference is used to find records updated since the last push out to other treating facilities.
2.01 PULL REQ 2;0 POINTER Multiple #351.821 351.821

  • DESCRIPTION:  
    This subfile contains all outstanding requests from external sites to pull this record. It is removed after the record is successfully sent to the requesting site.
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